Malignant Melanoma Metastatic to the Liver: A Cytomorphologic Comparative Study to Identify Reproducible Diagnostic Criteria

Luis E. De Las Casas, Murat Gokden, Sandra J. Baker, Soheila Korourian, Paul L. Hermonat, Hong You, Roberto N. Miranda, John E. Shalkham, Lori A. O'Brien, Perkins Mukunyadzi

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: To establish cytomorphologic criteria that might facilitate the identification of malignant melanoma (MM) cells with epithelioid (nevoid) morphology in fine needle aspiration biopsy material from the liver. STUDY DESIGN. Aspirated material from 18 cases of MM with epithelioid features and 24 cases of benign liver lesions (BLL) were examined. The cases were selected based on the availability of corresponding tissue biopsies, adequate cell block material or sufficient number of direct smears to perform immunocytochemical staining. The presence or absence of 7 cytologic criteria were reviewed, and the results were evaluated by multivariate regression analysis. RESULTS: All evaluated criteria were significant for identifying MM cells and differentiating them from reactive hepatocytes (P < .001). Uniform atypia, cell dyscohesion, eccentric nuclei and irregular nuclear membranes supported MM, whereas, monolayered sheets or cordlike arrangement; coarse, granular cytoplasm; and occasional transgressing endothelium in true tissue fragments were evidence of BLL. CONCLUSION: A systematic evaluation of the cytomorphologic features described in this study, in conjunction with the clinical and radiologic findings, can be used to render an immediate, confident and accurate diagnosis of MM metastatic to the liver.

Original languageEnglish (US)
Pages (from-to)32-38
Number of pages7
JournalActa Cytologica
Issue number1
StatePublished - 2004
Externally publishedYes


  • Aspiration biopsy
  • Liver cancer
  • Malignant melanoma
  • Metastasis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology


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